The use of the collaborative learning pedagogy to facilitate knowledge integration has been shown as an effective aid for cognitive integration in health professions students, particularly nursing undergraduate students . Due to the COVID-19 pandemic, however, newer ways of conducting collaborative learning sessions needed to be developed to adapt to these critical times when face-to-face classes potentially pose as a health risk.
This study evaluated a collaborative learning session using the online platform as an end-of-semester consolidation tutorial for first year undergraduate nursing students. The goal of the session was for students to integrate and apply the principles acquired from pathophysiology, pharmacology, and nursing practice. Previous runs of the collaborative learning activity consisted of face-to-face sessions wherein tutors from pathophysiology and pharmacology, and nursing practice co-facilitated the session. Students were randomly allocated to small groups to work together on an assigned question and share the answer to the class at a later time. As this model was impossible because of the pandemic, a virtual collaborative learning session was implemented which utilized the breakout rooms function for small group discussions.
Based on the findings from the focus group discussions of both student and faculty participants, the virtual collaborative activity has the potential to impact on learning and to be at par with face-to-face collaboration in terms of meeting learning objectives, as already noted by some studies [11, 20]. However, much has to be done to enhance its ability to truly engage students with their facilitators, with each other and with the content as face-to-face sessions could not be merely transferred virtually lock, stock, and barrel .
The educational success of any learning endeavour is reliant on multiple factors. A student-centered approach wherein students actively participate in their own learning fosters engagement. Engagement, meanwhile, aids in critical thinking needed for cognitive integration and deep learning to take place . Collaborative learning is a strategy that relies on teamwork to reach a common goal thus, achieving engagement and interaction is important. The student focus group discussion findings highlighted that the participants understood the need to engage during the collaborative learning session to benefit from it. Most students considered the richness of face-to-face interactions as more beneficial to their learning as compared to a virtual mode of collaboration; visual elements of face-to-face interactions, such as facial expressions and gestures, contribute positively to learning . However, in a study by Ku et al., , it was noted that students preferred to work online collaboratively as compared to face-to-face. This was in line with evidence showing that online is as valid as a face-to-face collaboration in supporting learning . As face-to-face learning could not just be converted wholesale to virtual learning for it to be effective in engaging students, the learners should first be motivated to engage . This is so because effective virtual collaboration requires an active interaction among all those involved . In addition, the participants of this study appropriately underscored that elements such as learners’ personality and cultural differences contribute to the success of any virtual learning activity. These factors were, in fact, also identified in literature as variables that influence virtual learning [25, 26]. Furthermore, the participants’ acknowledgement that discipline and control (e.g., students could not be forced to talk when they don’t feel like talking) are needed during virtual collaboration to avoid zoning in and out of the session, validates the importance of emotion regulation. Emotion regulation is “a sequence of transactional emotion episodes within a social event or scene, where the unit of analysis is not a lone person but a person in the context of other people who are mutually influencing one another within the bounds of a social episode” [27 p.13]. Hence, the effect of each learner to self-regulate his or her emotions during the session is intrinsic to its success. Indeed, the socio-emotional aspects of working collaboratively pose challenges that may undermine the effectiveness of collaborative learning. As such, these aspects, emotion regulation in particular, should be recognized and addressed for learning to occur [28, 29]
In supporting the collaborative process, the students highlighted that knowing their peers matter as group dynamics is vital to be able to achieve the goals of collaboration. Some students noted that this was lacking in the virtual collaborative session. This was because the students were only in the second semester of their first year in the nursing program when face-to-face teaching was converted to virtual teaching because of the pandemic. Furthermore, the collaborative learning session comprised two combined tutorial groups of first year students hence it is logical to expect that students only knew those who belonged to their own group since the first semester. A study by Janssen et al. , reported that positive perceptions of online communication and collaboration result from participants’ better familiarity with each other. Higher familiarity with the group would result in better teamwork and the ability to reach mutual agreements because of more favourable team satisfaction .
Students also mentioned that having a holistic view of the different disciplines included in the virtual collaboration would be helpful. When learners have the proper view of the pathophysiology and pharmacology, and nursing practice components, that is, that these disciplines are linked, then it is easier for them to collaborate hence, facilitating cognitive integration . Cognitive integration is one goal of collaborative learning, and the ability to formulate links in knowledge has clinical implications as it is associated with clinical reasoning.
The virtual collaborative learning experience also posed some issues that highlight the importance of considering practical nuances related to the implementation of the pedagogy. These practical concerns impact on the students’ experience of the virtual collaboration and affect their overall benefit from the activity. Some students were quite comfortable with technology, yet technical problems resulted when connectivity disconnects, that is, when their internet connectivity was disrupted, either by a slow internet speed or by a faulty hardware. In fact, a recent study noted that stability of the internet connection is one challenge that threatened the effectiveness of an online learning strategy . In addition, to effectively engage in any virtual learning, students need to first interact with technology. This could be a daunting exercise for those who are not so technically-savvy and could result in limiting the benefits of a virtual learning collaboration . Meanwhile, having an online collaborative class was favorable to some students as they valued being comfortable while engaging in the session. This means that students perceived that their learning was not compromised in any way because the virtual platform afforded them with efficiency, time management and comfort that facilitated their learning [2, 32]. Hence, it could not be denied that practical considerations also need to be initially studied when planning for a virtual collaborative learning activity as these could adversely negate the positive outcomes that educators intend to achieve.
Some of the ideas from the faculty interviews did overlap and were well-aligned with those of the students’. Learning to effectively manage is one of the themes that was generated. Faculty served as facilitators; hence they were expected to be initiators of the virtual collaboration. Faculty involved in this virtual collaborative learning highlighted that an advantage of a virtual platform was that they appreciated gaining more control of the session thus allowing them to manage the session more effectively. In a typical face-to-face collaborative learning, faculty faced the difficulty of organizing the class more efficiently for example, in terms of attendance-taking and preparing the audio-visual set-up in the classroom. These challenges were overcome by greater control provided by the virtual platform to the faculty in facilitating collaborative learning. This resonates with the findings of Glava and Glava  stressing the importance of time management in one online learning platform.
Leading and facilitating the virtual collaborative learning also required the faculty to be proactive and engaging. This was particularly difficult when it came to students who were naturally shy and quiet. Providing a means to participate in the virtual collaboration was definitely something that the faculty needed to address. Thus, the chat function of the virtual platform proved to be helpful, and faculty encouraged shy students to type in their questions. However, this chat function also served as a distraction as faculty were sometimes overwhelmed by multiple questions and comments from students within a short time span. Prior online or virtual teaching experience by educators is thus needed to use the online platform more effectively in teaching . Faculty involved in the virtual collaboration were experienced educators. However, they were new to virtual collaborative learning. Hence, it has been suggested that aside from experience, continuous training is needed to ensure the success of educators engaging in virtual pedagogy .
Another theme that was generated during the faculty focus group discussion was facing engagement constraints. The purpose of virtual collaboration was to facilitate engagement that brings about critical thinking and cognitive integration . However, there were inherent constraints to virtual collaboration. This finding was also highlighted during the student focus group interviews. For instance, the faculty noted that opinions of those who tend to be shyer were not verbalized and heard. This restricted the robustness of the interchange of ideas thus achieving true discussion is limited, restricting the learning experience.
While some student participants underscored the fact that they did not know their peers, the faculty also highlighted that it is also imperative that faculty know the students. Having a relationship matters and, in this case, this is akin to knowing the students involved in the collaboration. This is in line with the findings of Smith and Crowe , which noted that social connection with students and teaching presence are vital to educators in virtual teaching and learning.
The ultimate goal of the virtual collaborative learning session was to help students integrate concepts and knowledge gained from pathophysiology, pharmacology, and nursing practice. The session was designed to apply information from these disciplines to a case study as the students worked in small groups using the breakout rooms. Achieving integration was found by some faculty to pose challenges. Although both pathophysiology and pharmacology, and nursing practice facilitators were present during the session, having them facilitate the session one after the other did not mirror true collaboration. In fact, one faculty interviewed noted that because of having this clear delineation, integrated teaching or co-facilitation did not necessarily happen as the session was more of a “two-in-one” session. Literature has indeed mentioned that students mimic how educators collaborate to become collaborators themselves . Hence, when facilitation becomes segmented, collaboration between the facilitators become non-existent and integration may be difficult to realize. Clarifying principles of integration is vital for faculty prior to engaging in a virtual collaborative activity. In addition, the design of the questions used during the virtual collaborative learning is also an important element in achieving cognitive integration. An effective questioning technique promotes critical thinking , and this is a significant element of being able to aid students synthesize knowledge. Guide questions used in collaboration should thus be better crafted to meet this goal as effective question structure is key.
Although steps were undertaken to ensure the rigor of the study, limitations inevitably exist and should be presented. Firstly, the virtual collaboration was done only once at the end of the semester. Multiple experiences with the pedagogy would have provided a richer feedback from the participants that ensures validity. Secondly, the focus group interviews were conducted a few months after the virtual collaboration, thus vivid recollection of the activity by the participants might be limited. Immediate focus group discussions should be considered when a similar study is implemented in the future to elicit timely feedback reflective of the participants’ experience. Lastly, the study would benefit from a quantitative component. A mixed methods study involving a quantitative measure of variables such as online readiness, level of engagement, communication, and critical thinking, among others would be valuable. Similar future studies should consider including these measures.